PREVENTIVE MEDECINE: FITS (CONVULSIONS)
What are they?
Sudden spasms of the muscles caused by an abnormal burst of activity in the brain. Convulsions are common in babies and young children. Epilepsy, which causes one kind of fit, is relatively rare, so you should not jump to the conclusion that your child’s fit is epileptic in origin.
What causes them?
• The most common cause of fits (in children) by far is a raised temperature. These so-called febrile convulsions occur most often between the age of 6 months and 3 years old. They are rare after the age of 5 years.
The most usual causes of such high fevers are tonsillitis, acute ear infections, urinary infections and measles. There is often a family history of febrile convulsions during infancy.
• Epilepsy. This is a condition in which a person has repeated losses of consciousness. There are more than 100 causes for such attacks but for the vast majority of people with epilepsy there is no known, provable cause as such. Epilepsy starts at any age but usually during infancy. Most epileptic children are normal mentally and physically when the attacks start and most lead happy and normal lives with the help of drugs.
• Epilepsy can be triggered by late nights, too much alcohol, a high fever, flashing lights, and many other things. It can now be controlled in the vast majority of both adults and children.
• Hypoglycemia.
• Infections of the brain such as encephalitis, rabies and tetanus.
• Shortage of vitamin B6 in children.
• Certain poisons and intoxications, including lead, arsenic and alcohol poisoning.
• Head injuries.
• Hysteria. Some hysterical people (usually women) have convulsions but only in front of an audience-they never occur when they are alone.
Prevention
The preventive measures that can be taken against the above causes are obvious and some, such as hysteria, cannot be prevented. The two main causes of convulsions-fevers in children and certain precipitating factors in epilepsy-can, however, be prevented.
• If a child has a high fever the parent is in a difficult dilemma because there is no doubt that the fever is valuable in killing the bacteria or virus that caused it in the first place. It used to be thought that fevers should be lowered by using aspirin or similar drugs but this is now disputed. A substance called endogenous pyrogen produced during fevers enhances the body’s immunity to disease. Once this pyrogen is produced it circulates in the blood to the brain and stimulates the body’s thermostat to produce substances called prostaglandins which set the body’s temperature to normal. Endogenous pyrogen increases the mobility of white blood cells and stimulates the production of proteins to fight infection. Antibiotics, it appears, also work better at high temperatures.
However, high fevers have damaging effects too, especially over about 104° or 105°F. The secret then is to start lowering the child’s temperature before it gets this high-say at 102°, or earlier if the baby or child is irritable. Take all the clothes off the child and lay him or her on a waterproof sheet on the bed. Cool his or her face, trunk and limbs with tepid (just warm) water so as to make the surface blood vessels dilate and lose heat. Cold water makes them contract and conserves heat. Wrap cloths soaked in tepid water around the child’s groin and neck, and check his or her temperature every 10 minutes until it is normal. Don’t give aspirin unless the fever is very high (over 103°F/39.4°C). Give the child plenty of drinks (preferably water or dilute fruit juice).
The above procedure will prevent the vast majority of feverish fits. If ever your child has a fit, don’t panic but do tell the doctor.
Prevention of epileptic fits is far more difficult because the cause is rarely found. If you find that tiredness, alcohol, flashing lights or TV bring them on, you will have to avoid these things. You can avoid the TV problem by watching in a light room and not going near the set to switch it off or to adjust it. Most photosensitive people can overcome their problem by covering one eye with the palm of their hand. The effects of flashing lights on water can be reduced by wearing polarized spectacles. Sometimes psychological treatments can prevent attacks. The majority of preventive measures for true epilepsy centre around adequate drug control.
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